Imagine going to the doctor and not being able to understand the medical news being delivered or not feeling comfortable in the office because the staff members don't look like you.

Those are real issues Rockford-area hospitals and places like Crusader Community Health face every day. Anyone can walk through their doors requesting health care services, and they have to be prepared for the unexpected.

Crusader's telephone interpreting service helped people in more than 40 languages make appointments last year. Languages such as Arabic, Burmese, Karen, Spanish and Swahili were the most common.

Employees say diversity starts from the top down at Crusader. The federally qualified community health center has about 300 employees, and about 40 percent of those are minorities.

"We are the melting pot," said Rhashonda Williams, Crusader's director of human resources. "I'm proud to say Crusader is definitely the pacesetter in our community when it comes to having a diversified workforce."

Crusader employees also must complete cultural competency training. About 27 percent of Crusader's patients are Hispanic, and about 30 percent are African American.

"What really makes us different than a lot of organizations is that we're not really being diverse because it's the thing to do as much as it's something that we need to do to ensure that we provide health care," said Shelton Kay, Crusader's community services director. "One of the things we really have to work at is having a welcoming environment so when someone comes here, they feel that we're here to take care of them. Otherwise, they may not come back.

"It's the little things like that, the comfort level, the relationship, the seeing people that look like them and talk like them. Those are the things that link them into things they need. And I think we are mindful of the fact that we are providing a service to people who really need this."

Kay also said staff can't make assumptions about patients and who they feel comfortable with. For example, a young African-American man might respond well to an older white woman because of a teacher he knew, or a Hispanic patient might want to work with English-speaking staff to practice her language skills.

Elda Franco, Crusader's interpreting manager, said she has helped staff learn how to address older Hispanic patients, who traditionally should be referred to a "ma'am" or "sir" or by "Mr." or "Mrs." and their last names rather than by their first names.

"It's considered disrespectful to address them any other way, so the training is very helpful," Franco said.

Page 2 of 2 - SwedishAmerican Interpreter Supervisor Leo Medrano started doing interpreter work at Crusader and moved to the health system to work with a broader base of patients. Medrano said patients are grateful to get medical news delivered in their own languages.

The health system has three full-time Spanish-speaking interpreters and Medrano is a working supervisor who jumps in when needed. Another interpreter is being hired for the health system's new Regional Cancer Center.

He said interpreters spent about 190,000 minutes with Spanish-speaking patients during the last fiscal year. The phone service used about 65,000 minutes, which covered 7,200 patients.

The video service used 42,000 minutes, and sign language interpretation was needed for 300 patients. Those totals have increased ever since 2010, Medrano said, and are expected to increase again during this current fiscal year.

"Communication is one of the keys to good quality outcomes for patients," said Sharon Whelan, SwedishAmerican's director of patient advocacy and holistic health and wellness services. "We're interacting with people at the most personal times in their lives, when their culture brings them comfort.

The hospitals also do cultural competency training for their staff members, which helps teach sensitivity to different cultural traditions and how to approach patients in certain situations.

For example, some cultures are very patriarchal, and approaching the head of the household or the family could be very important, said Lucy Rivas, director of human resources at OSF Saint Anthony Medical Center.

"It's a complex environment we have to work in," Rivas said. "Cultural dynamics exist, but so does HIPAA."

Hospitals, schools and other health care organizations also try to promote a more diverse workforce by encouraging younger students to choose health and science careers.

Rockford Health System has a minority nursing scholarship program for students going into the nursing field and who've been accepted into a nursing program. The information is distributed to local and regional high schools, as well as area colleges and eligible health system employees.

In 2013, two graduates who received scholarships enrolled in the health system's residency program. Scholarship applications for this year are due back to the health system by April 15.

"Our community is changing," said Rozene Smith, director of human resources and diversity at Rockford Health System. "We need to be able to communicate well and know the different cultures, and know about our patients' experiences. We really need to look like our community."